Hair Transplantation

Hair transplantation involves relocating (transplanting) bald resistant hair follicles from the back and sides of the head (the donor areas) to a person’s bald or thinning areas. The transplanted hair follicles will typically grow hair for a lifetime because they are genetically resistant to going bald. In recent years hair transplantation techniques have evolved from using large plugs and mini grafts to exclusively using large numbers of small grafts that contain from between 1 to 4 hairs.

Since hair naturally grows in follicles that contain groupings of 1 to 4 hairs, today’s most advanced techniques transplant these naturally occurring 1 – 4 hair "follicular units" in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking nature hair for hair. This recent hair transplant procedure is called "Follicular Unit Transplantation." Given the improved naturalness of hair transplantation surgery hair loss sufferers are increasingly selecting this hair loss treatment.

Hair Transplant Procedure

At an initial consultation, the surgeon analyzes the patient's scalp, discusses his preferences and expectations, and advises him/her on the best approach (e.g., single vs. multiple sessions) and what results might reasonably be expected.

For several days prior to surgery the patient refrains from using any medicines, or alcohol, which might result in intraoperative bleeding and resultant poor "take" of the grafts. Pre-operative antibiotics are commonly prescribed to prevent wound or graft infections.

Cost

In recent years hair transplants have become less expensive. Prices typically range from $3.00 to $7.00 per graft, with $4 to $5 per graft being about average. Normally the price per graft also drops as the size of the surgical session increases. Depending on the needs of the patient a typical surgical session can range from 1,500 to over 4,000 grafts, resulting in a total cost of approximately $6000 to $15,000. A few clinics offer larger sessions of up to 6000 grafts in one sitting.

Hair Transplant Surgery

Transplant operations are performed on an outpatient basis, with mild sedation (optional) and injected topical anesthesia, and typically last about four hours. The scalp is shampooed and then treated with an antibacterial chemical prior to the donor scalp being harvested.

In the usual follicular unit procedure, the surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth. The excised strip is about 1-1.5 x 15-30 cm in size. While he is closing the resulting wound, assistants begin to dissect individual follicular unit grafts from the strip. Working with binocular microscopes, they carefully remove excess fibrous and fatty tissue while trying to avoid damage to the follicular cells that will be used for grafting.

The surgeon then uses a fine needle to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. The assistants generally do the final part of the procedure, inserting the individual grafts in place.

Post-operative care

Advances in wound care allow for semi-permeable dressings, which allow seepage of blood and tissue fluid, to be applied and changed at least daily. The vulnerable recipient area must be shielded from the sun, and shampooing is started two days after the surgery. Some surgeons will have you shampoo the day after surgery. Shampooing is important to prevent scabs from occurring around the hair shaft. Scabs adhere to the hair shaft and increase the risk of loosing newly transplanted hair follicles during the first 7 to 10 days post-op.

During the first ten days, virtually all of the transplanted hairs, inevitably traumatized by their relocation, will fall out ("shock loss"). After two to three months new hair will begin to erupt from the moved follicles. The patient's hair will grow normally, and continue to thicken through the next six to nine months. Any subsequent hair loss is likely to be only from untreated areas. Some patients elect to use medications to retard such loss, while others plan a subsequent transplant procedure to deal with this eventuality.